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When Mike Cernovich, one of the most prominent alt-right internet trolls supporting Donald Trump, was interviewed on 60 Minutes, he used the platform to spread conspiracy theories about Hillary Clinton’s health and to allege that she is involved with pedophilic sex trafficking operations. But he also declared his belief in single-payer health care.

“I believe in some form of universal basic income,” he told CBS’s Scott Pelley, citing concerns about technological unemployment. “I’m pro-single-payer health care. Is that right-wing or is that left-wing anymore? Well, if you have a lot of people, a large swath of the company, or country, are suffering, then I think that we owe it to all Americans to do right by them and to help them out.”

This might seem like a bizarre position for a far-right conspiracy theorist to take. Single-payer health care, after all, entails nationalizing most or all of the health insurance industry and having the government set prices for doctors’ services. Conservatives in America have spent the better part of the past century arguing that the idea is socialistic, would lead to long waits for lifesaving treatment, and would give the government power over the life and death of its citizens.

But Cernovich is less a traditional conservative than he is a Trumpist — and Trumpism in its purest, alt-right variety cares more about white working-class identity politics than traditional conservatism. More and more, Trump fans are seeing single-payer as part of that.

Alt-rightists and other Trump-loyal conservatives — Richard Spencer, VDARE writer and ex–National Review staffer John Derbyshire, Newsmax CEO and Trump friend Christopher Ruddy, and onetime Donald Trump Jr. speechwriter and Scholars & Writers for Trump head F.H. Buckley — all endorsed various models of single-payer in recent months and years.

Even elites in the alt-right mold who once deplored single-payer are changing their tune. Pat Buchanan, the paleoconservative three-time presidential candidate whose white identity politics and fiercely anti-trade and anti-immigration stances helped inspire the modern alt-right, had free market views on health care in the 1990s and condemned Obamacare as a scheme to kill Grandma in 2009. This week, he told me in an email he has “not taken any position on single-payer, and [has] pretty much stayed out of the Obamacare repeal-and-replace debate.”

You can have market-based health care coupled with a strong, and sometimes unreliable, charitable ethos. Or, you can have some sort of national health care, whether it’s government-owned like the UK, government-financed like Canada, or a very heavily regulated, and only nominally private system like Germany. The idea is to get health care for sick people.

Then there’s the exceptionalist United States. Whether it’s Big Business foolishly bankrolling group health insurance to block national health care, a sort of excise tax on labor, or Congress giving away the Treasury to Big Medicine to pass Medicare, the idea is to buy health care for selected constituencies to serve poorly articulated political ends. If you’re not in a selected constituency, you can go whistle.

We’ll get Medicare for All, not because national health is so wonderful, but because the current system and its underlying motives are radically destructive of human thought and feeling.

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Interesting article. Ultimately I don’t think it’s that complicated: the Cold War is over and the ideological debates over capitalism vs. socialism are over.

All Western countries, including the United States, have more or less converged on the ideas of regulated capitalism plus a welfare state funded by progressive taxation. The disagreements on these ideas really only amount to tinkering around the margins.

New era, new issues. The real issue now, in every Western country, is whether we turn into Third World and/or Islamic countries through mass immigration. The alt-right, Trump, Buchanan, Derbyshire, et al understand this.

The real issue now, in every Western country, is whether we turn into Third World and/or Islamic countries through mass immigration.

Agree with this, but have to extend it a bit. The issue is "invite the world, invade the world" vs "don't invite the world, don't invade the world". There are obviously two more variations to this, but it seems that most of people that I am aware of are in one of the two main camps, there are still some liberals out there that believe in "invite the world, don't invade the world", but their numbers are shrinking rapidly as they are now aware that "invading the world" means forcing their ideology on everyone else.

Current Crony driven health care “reform” efforts only move the “who pays” food around the plate doing next to nothing to reduce the actual cost of service.

Both political parties avoid the required existential objective – significantly reduce the aggregate per capita cost of health care in the U.S. while still delivering quality services in a timely manner. German health care costs 47% less per capita than American per capita cost. And Germans are not falling over in the street from illness.

An objectives statement by both Congress and the President should put a stake in the ground at a specific per capita cost reduction target. Because there are alternative models out there with empirical cost structures, that objective is not theoretically infeasible. Reducing the U.S. – German per capita differential from 47% to just 37% would free up ~ $2.9 Trillion. The German system is not perfect, but the Perfect is the enemy of the Good Enough, so why not harvest what works from other systems?

That’s easy enough, because then EVERY Crony stakeholder would have to be lined up for some level of hair-cut. And nobody in DC has the will to take up the clippers.

The U.S. health care model can’t be reformed, it can only be blown up. My prediction is a populist revolt with or without Republican pseudo “reform” when a critical mass of people are afraid to go to the doctor because they can’t afford it.

Both political parties avoid the required existential objective – significantly reduce the aggregate per capita cost of health care in the U.S. while still delivering quality services in a timely manner. German health care costs 47% less per capita than American per capita cost. And Germans are not falling over in the street from illness.

I just discovered this most excellent analysis last night (see below). Maybe it can be re-published in its entirety here at the Unz Review?

Americans eat way too much sugar:

I agree with you, that diet and obesity, etc. probably play an important role in this regard. There is research which connects higher prostate cancer risk with higher (refined) sugar consumption, and specifically with artificial sweeteners, like aspartame, etc., which could explain why the U.S. has the highest prostate cancer prevalence among the industrialized nations; “Diet” soft drinks are a more popular beverage in the U.S.: http://www.medicaldaily.com/soda-day-raises-mans-aggressive-prostate-cancer-risk-40-percent-243674 [...] New concerns about diet sodas

In my prior few posts I made a strong case that the United States’ exceptionally high health care expenditures are well explained by its unusually high material standard of living. In response to this several people I have interacted with have fallen back to the position that something still must obviously be uniquely wrong with the US health care system because US outcomes are significantly below what one might expect given its level of spending. They believe it cannot be a coincidence that the country that spends so much more than expected (according to naive expectations) also gets worse outcomes than expected and generally gets worse outcomes than the most developed countries of predominantly European and Asian origin.

In this blog post I will address the so-called “outcomes” dimension and explain why these apparently sub-par outcomes are not only not otherwise inexplicable, but can actually be explained in a fairly straight forward and parsimonious fashion. For the moment, I will narrow my focus on the subset of factors that drive US health outcomes significantly below naive expectations (not necessarily the full residual) and that I have good reason to suspect are significantly causally related to the expenditures issue. Later, perhaps in another lengthy blog post, I will address other factors that are mostly orthogonal to expenditures and that further affect US health outcomes.

Current Crony driven health care "reform" efforts only move the "who pays" food around the plate doing next to nothing to reduce the actual cost of service.

Both political parties avoid the required existential objective - significantly reduce the aggregate per capita cost of health care in the U.S. while still delivering quality services in a timely manner. German health care costs 47% less per capita than American per capita cost. And Germans are not falling over in the street from illness.

An objectives statement by both Congress and the President should put a stake in the ground at a specific per capita cost reduction target. Because there are alternative models out there with empirical cost structures, that objective is not theoretically infeasible. Reducing the U.S. – German per capita differential from 47% to just 37% would free up ~ $2.9 Trillion. The German system is not perfect, but the Perfect is the enemy of the Good Enough, so why not harvest what works from other systems?

That’s easy enough, because then EVERY Crony stakeholder would have to be lined up for some level of hair-cut. And nobody in DC has the will to take up the clippers.

The U.S. health care model can't be reformed, it can only be blown up. My prediction is a populist revolt with or without Republican pseudo "reform" when a critical mass of people are afraid to go to the doctor because they can’t afford it.

Both political parties avoid the required existential objective – significantly reduce the aggregate per capita cost of health care in the U.S. while still delivering quality services in a timely manner. German health care costs 47% less per capita than American per capita cost. And Germans are not falling over in the street from illness.

I just discovered this most excellent analysis last night (see below). Maybe it can be re-published in its entirety here at the Unz Review?

Americans eat way too much sugar:

I agree with you, that diet and obesity, etc. probably play an important role in this regard. There is research which connects higher prostate cancer risk with higher (refined) sugar consumption, and specifically with artificial sweeteners, like aspartame, etc., which could explain why the U.S. has the highest prostate cancer prevalence among the industrialized nations; “Diet” soft drinks are a more popular beverage in the U.S.: http://www.medicaldaily.com/soda-day-raises-mans-aggressive-prostate-cancer-risk-40-percent-243674 [...] New concerns about diet sodas

In my prior few posts I made a strong case that the United States’ exceptionally high health care expenditures are well explained by its unusually high material standard of living. In response to this several people I have interacted with have fallen back to the position that something still must obviously be uniquely wrong with the US health care system because US outcomes are significantly below what one might expect given its level of spending. They believe it cannot be a coincidence that the country that spends so much more than expected (according to naive expectations) also gets worse outcomes than expected and generally gets worse outcomes than the most developed countries of predominantly European and Asian origin.

In this blog post I will address the so-called “outcomes” dimension and explain why these apparently sub-par outcomes are not only not otherwise inexplicable, but can actually be explained in a fairly straight forward and parsimonious fashion. For the moment, I will narrow my focus on the subset of factors that drive US health outcomes significantly below naive expectations (not necessarily the full residual) and that I have good reason to suspect are significantly causally related to the expenditures issue. Later, perhaps in another lengthy blog post, I will address other factors that are mostly orthogonal to expenditures and that further affect US health outcomes.

``Big Sugar'' and ``Big Soda'' are the main culprits, in my opinion. ``Big Pharma'' and ``Big Health Care'' are merely beneficiaries.

Science Explains Why Bill Gates Guzzles Diet Coke Constantly

A 2012 study in Physiology & Behavior found that the cognitive reward process of diet soda drinkers was unusually altered. Habitual diet soda drinking, the researchers found, made it harder for the brain to distinguish between real and artificial sugar — eventually causing a degree of numbness to the pleasurable experience of consuming actual sugar.

This might also explain, the researchers theorize, why consuming diet sodas is actually linked to an increase in weight gain. Besides the mental game that Big Sugar has played, convincing us that diet sodas are the healthier choice, the delay in reward might signal to you that you should grab that second (or third) Diet Coke.

Lastly, artificial sweeteners, precisely because they are sweet, encourage sugar craving and sugar dependence. Repeated exposure trains flavor preference [54]. A strong correlation exists between a person’s customary intake of a flavor and his preferred intensity for that flavor. Systematic reduction of dietary salt [55] or fat [56] without any flavorful substitution over the course of several weeks led to a preference for lower levels of those nutrients in the research subjects. In light of these findings, a similar approach might be used to reduce sugar intake. Unsweetening the world’s diet [15] may be the key to reversing the obesity epidemic.

Charlottesville, Va. — On Monday, an article in JAMA Internal Medicine reported that in the 1960s, the sugar industry paid Harvard scientists to publish a study blaming fat and cholesterol for coronary heart disease while largely exculpating sugar. This study, published in the prestigious New England Journal of Medicine in 1967, helped set the agenda for decades of public health policy designed to steer Americans into low-fat foods, which increased carbohydrate consumption and exacerbated our obesity epidemic.

This revelation rightly reminds us to view industry-funded nutrition science with skepticism and to continue to demand transparency in scientific research. But ending Big Sugar’s hold on the American diet will require a broader understanding of the various ways in which the industry, for 150 years, has shaped government policy in order to fuel our sugar addiction.

Both political parties avoid the required existential objective – significantly reduce the aggregate per capita cost of health care in the U.S. while still delivering quality services in a timely manner. German health care costs 47% less per capita than American per capita cost. And Germans are not falling over in the street from illness.

I just discovered this most excellent analysis last night (see below). Maybe it can be re-published in its entirety here at the Unz Review?

Americans eat way too much sugar:

I agree with you, that diet and obesity, etc. probably play an important role in this regard. There is research which connects higher prostate cancer risk with higher (refined) sugar consumption, and specifically with artificial sweeteners, like aspartame, etc., which could explain why the U.S. has the highest prostate cancer prevalence among the industrialized nations; “Diet” soft drinks are a more popular beverage in the U.S.: http://www.medicaldaily.com/soda-day-raises-mans-aggressive-prostate-cancer-risk-40-percent-243674 [...] New concerns about diet sodas

In my prior few posts I made a strong case that the United States’ exceptionally high health care expenditures are well explained by its unusually high material standard of living. In response to this several people I have interacted with have fallen back to the position that something still must obviously be uniquely wrong with the US health care system because US outcomes are significantly below what one might expect given its level of spending. They believe it cannot be a coincidence that the country that spends so much more than expected (according to naive expectations) also gets worse outcomes than expected and generally gets worse outcomes than the most developed countries of predominantly European and Asian origin.

In this blog post I will address the so-called “outcomes” dimension and explain why these apparently sub-par outcomes are not only not otherwise inexplicable, but can actually be explained in a fairly straight forward and parsimonious fashion. For the moment, I will narrow my focus on the subset of factors that drive US health outcomes significantly below naive expectations (not necessarily the full residual) and that I have good reason to suspect are significantly causally related to the expenditures issue. Later, perhaps in another lengthy blog post, I will address other factors that are mostly orthogonal to expenditures and that further affect US health outcomes.

“Big Sugar” and “Big Soda” are the main culprits, in my opinion. “Big Pharma” and “Big Health Care” are merely beneficiaries.

Science Explains Why Bill Gates Guzzles Diet Coke Constantly

A 2012 study in Physiology & Behavior found that the cognitive reward process of diet soda drinkers was unusually altered. Habitual diet soda drinking, the researchers found, made it harder for the brain to distinguish between real and artificial sugar — eventually causing a degree of numbness to the pleasurable experience of consuming actual sugar.

This might also explain, the researchers theorize, why consuming diet sodas is actually linked to an increase in weight gain. Besides the mental game that Big Sugar has played, convincing us that diet sodas are the healthier choice, the delay in reward might signal to you that you should grab that second (or third) Diet Coke.

Lastly, artificial sweeteners, precisely because they are sweet, encourage sugar craving and sugar dependence. Repeated exposure trains flavor preference [54]. A strong correlation exists between a person’s customary intake of a flavor and his preferred intensity for that flavor. Systematic reduction of dietary salt [55] or fat [56] without any flavorful substitution over the course of several weeks led to a preference for lower levels of those nutrients in the research subjects. In light of these findings, a similar approach might be used to reduce sugar intake. Unsweetening the world’s diet [15] may be the key to reversing the obesity epidemic.

Charlottesville, Va. — On Monday, an article in JAMA Internal Medicine reported that in the 1960s, the sugar industry paid Harvard scientists to publish a study blaming fat and cholesterol for coronary heart disease while largely exculpating sugar. This study, published in the prestigious New England Journal of Medicine in 1967, helped set the agenda for decades of public health policy designed to steer Americans into low-fat foods, which increased carbohydrate consumption and exacerbated our obesity epidemic.

This revelation rightly reminds us to view industry-funded nutrition science with skepticism and to continue to demand transparency in scientific research. But ending Big Sugar’s hold on the American diet will require a broader understanding of the various ways in which the industry, for 150 years, has shaped government policy in order to fuel our sugar addiction.

Ultimately big insurance has to go, or be diminished, as some version of single payer or universal health policy is the only solution.

It almost sounded like that was what Trump had in mind when he described what his health plan would be like, but now we know differently.

In the UK there is a national health service that provides free at point of service care to everyone, but even so about 10% of the population take out private health care insurance, because they believe it offers them value, like for example the ability to skip waiting lists, getting superior accommodations and food, etc. People also pay to take out travel health insurance policies, especially if they are planning to visit the US.

US health insurance companies need to learn how to offer plans that people actually want or that their employers want employees to have, not ones that they are mandated to buy, that is all.

Once everyone has personal health coverage, then other costs can come down, like Workers Comp insurance, driver’s insurance, etc. as there will be no need for them.

Another advantage the UK has in health care cost containment that hospitals and primary care practices have no army of accountants or billing departments, because there is no individual billing or processing of payments , except for foreign visitors, hence saving billions of pounds/dollars.

There are actually MORE bureaucrats and other non-medical people running the British National Health Service than in other countries, the USA included. There are many life-saving procedures and drugs that the NHS will not provide because of cost...hence "death panels" are alive and well.
Closer to home, the Canadian system works well for cuts and bruises and other minor medical procedures, but for complicated procedures, the wait can be interminable. In fact, in border cities, such as Detroit, there are "special agreements" with OHIP (Ontario Health Insurance Program) and Detroit hospitals to provide some of the specialized treatments that are unavailable in Canada on a timely basis.
Canadian medical personnel are first-rate, but have to work under a system that undermines their professional judgment due to delays in treatment.
A number of years ago, some Canadian hospitals were making their CAT scanners available to veterinarians for animal scans while human patients were forced to wait for CAT scan use, as veterinarians would pay cash up front.
Also, if and when Canadian hospitals run out of money (prior to the new fiscal year) they shut down operations.
To its credit, the Canadian Supreme Court ruled that its citizens could purchase private health insurance. Previous to the court's decision, it was illegal to purchase "health care" outside of the government system.
The Canadian system works as well as it does as Canada's population is much less than that of the USA and is mostly concentrated within 100 miles of the US border.

Interesting article. Ultimately I don't think it's that complicated: the Cold War is over and the ideological debates over capitalism vs. socialism are over.

All Western countries, including the United States, have more or less converged on the ideas of regulated capitalism plus a welfare state funded by progressive taxation. The disagreements on these ideas really only amount to tinkering around the margins.

New era, new issues. The real issue now, in every Western country, is whether we turn into Third World and/or Islamic countries through mass immigration. The alt-right, Trump, Buchanan, Derbyshire, et al understand this.

The real issue now, in every Western country, is whether we turn into Third World and/or Islamic countries through mass immigration.

Agree with this, but have to extend it a bit. The issue is “invite the world, invade the world” vs “don’t invite the world, don’t invade the world”. There are obviously two more variations to this, but it seems that most of people that I am aware of are in one of the two main camps, there are still some liberals out there that believe in “invite the world, don’t invade the world”, but their numbers are shrinking rapidly as they are now aware that “invading the world” means forcing their ideology on everyone else.

Both political parties avoid the required existential objective – significantly reduce the aggregate per capita cost of health care in the U.S. while still delivering quality services in a timely manner. German health care costs 47% less per capita than American per capita cost. And Germans are not falling over in the street from illness.

I just discovered this most excellent analysis last night (see below). Maybe it can be re-published in its entirety here at the Unz Review?

Americans eat way too much sugar:

I agree with you, that diet and obesity, etc. probably play an important role in this regard. There is research which connects higher prostate cancer risk with higher (refined) sugar consumption, and specifically with artificial sweeteners, like aspartame, etc., which could explain why the U.S. has the highest prostate cancer prevalence among the industrialized nations; “Diet” soft drinks are a more popular beverage in the U.S.: http://www.medicaldaily.com/soda-day-raises-mans-aggressive-prostate-cancer-risk-40-percent-243674 [...] New concerns about diet sodas

In my prior few posts I made a strong case that the United States’ exceptionally high health care expenditures are well explained by its unusually high material standard of living. In response to this several people I have interacted with have fallen back to the position that something still must obviously be uniquely wrong with the US health care system because US outcomes are significantly below what one might expect given its level of spending. They believe it cannot be a coincidence that the country that spends so much more than expected (according to naive expectations) also gets worse outcomes than expected and generally gets worse outcomes than the most developed countries of predominantly European and Asian origin.

In this blog post I will address the so-called “outcomes” dimension and explain why these apparently sub-par outcomes are not only not otherwise inexplicable, but can actually be explained in a fairly straight forward and parsimonious fashion. For the moment, I will narrow my focus on the subset of factors that drive US health outcomes significantly below naive expectations (not necessarily the full residual) and that I have good reason to suspect are significantly causally related to the expenditures issue. Later, perhaps in another lengthy blog post, I will address other factors that are mostly orthogonal to expenditures and that further affect US health outcomes.

So what about breeding rates?

Why should responsible citizens who have minimal or no children be forced to pay for those who have many children and cannot support them?
i.e.: Mestizos, Muslims, Africans

A similar foolishness Republicans/Conservatives peddle/believe, is around abortion and contraception. Populist Republicans/Trumpists/The Catholic Bannon-Milo Crew want to put a stop to immigration, because they, rightly, say, that Democrats use immigration to import more Democrat voters into the country; but then they turn around and oppose Planned Parenthood and want to ban abortion, etc., when high birth rates among African-Americans and Latino-Americans, who overwhelmingly vote Democrat, has the exact same effect; an increase in the number of Democrat voters. Their policy is probably even worse and more dysgenic, because lower IQ persons usually have more children on average, if they are not provided or cannot afford contraceptives.

Return on Investment: A Fuller Assessment
of the Benefits and Cost Savings of the US
Publicly Funded Family Planning Program

”This investment resulted in net government savings of $13.6 billion
in 2010, or $7.09 for every public dollar spent.”
[...]
The Alt Right and its ideas will continue on long after Donald Trump has left office. If he wants to leave a lasting legacy based on science and common sense ( “common sense conservatism” how he referred to it himself during the campaign) he will have to adopt reality-based Alt Right ideas/policies and employ (more) Alt Right personnel and advisors.

John Roberts is a devout Catholic and most likely a loyal papal servant. The Vatican favors universal health care, because it benefits its flock, especially less well-off Hispanic-Americans.
[...]
While the United States Conference of Catholic Bishops opposed the Affordable Care Act over its contraception and abortion coverage, the Catholic Health Association broke rank and consistently supported the law for making practical progress on helping working-class families and the poor. Obama even gave CHA president Sister Carol Keehan one of the 21 pens he used to sign the bill into law in 2010. [...]
“The Catholic Church in the United States supports a universal health care law that both protects the poor and the Church’s right to practice its faith without undue interference from the federal government. The President needs to convince the Catholic Church that’s exactly what Obamacare does.”

- http://www.unz.com/article/pizzagate/#comment-1676150

The Trump candidacy is tapping into a change in consciousness that is being produced by white demographic displacement, and the Alt Right deserves a great deal of credit for making people aware of this fact and helping to articulate both the problems we are facing and a way forward. Whether Trump wins or loses, those forces will still be at work.

A similar foolishness Republicans/Conservatives peddle/believe, is around abortion and contraception. Populist Republicans/Trumpists/The Catholic Bannon-Milo Crew want to put a stop to immigration, because they, rightly, say, that Democrats use immigration to import more Democrat voters into the country; but then they turn around and oppose Planned Parenthood and want to ban abortion, etc., when high birth rates among African-Americans and Latino-Americans, who overwhelmingly vote Democrat, has the exact same effect; an increase in the number of Democrat voters. Their policy is probably even worse and more dysgenic, because lower IQ persons usually have more children on average, if they are not provided or cannot afford contraceptives.

Return on Investment: A Fuller Assessment
of the Benefits and Cost Savings of the US
Publicly Funded Family Planning Program

”This investment resulted in net government savings of $13.6 billion
in 2010, or $7.09 for every public dollar spent.”
[...]
The Alt Right and its ideas will continue on long after Donald Trump has left office. If he wants to leave a lasting legacy based on science and common sense ( “common sense conservatism” how he referred to it himself during the campaign) he will have to adopt reality-based Alt Right ideas/policies and employ (more) Alt Right personnel and advisors.

John Roberts is a devout Catholic and most likely a loyal papal servant. The Vatican favors universal health care, because it benefits its flock, especially less well-off Hispanic-Americans.
[...]While the United States Conference of Catholic Bishops opposed the Affordable Care Act over its contraception and abortion coverage, the Catholic Health Association broke rank and consistently supported the law for making practical progress on helping working-class families and the poor. Obama even gave CHA president Sister Carol Keehan one of the 21 pens he used to sign the bill into law in 2010. [...]
“The Catholic Church in the United States supports a universal health care law that both protects the poor and the Church’s right to practice its faith without undue interference from the federal government. The President needs to convince the Catholic Church that’s exactly what Obamacare does.”

The Trump candidacy is tapping into a change in consciousness that is being produced by white demographic displacement, and the Alt Right deserves a great deal of credit for making people aware of this fact and helping to articulate both the problems we are facing and a way forward. Whether Trump wins or loses, those forces will still be at work.

I support socialized medicine because (actual) free speech will continue its current hiatus until most of us are no longer completely at the mercy of employers. I support other forms of public assistance for the same reason.

single payer type healthcare systems can work well if
- you have a more or less homogenous (aka distantly related) population
- the proportion of people subsidizing is higher than the proportion being subsidized

those conditions used to apply in Europe but after mass immigration they no longer do.

they didn’t apply in the US in the past and after mass immigration it’s worse now.

First, a pet peeve: the issue should be framed in terms of how a society FINANCES health care. Health care is for all intents and purposes a right i.e. by law a hospital cannot refuse a emergency room patient for want of health insurance), not so the financing of health care. Of the seven major industrialized nations (US, Canada, England, Germany, France, Italy and Japan) all but the US have some form of socialized health insurance for the masses. No, socialized health insurance is not really “insurance” at all– but that’s another matter). America spends far more in health care financing than the other six even though the life expectancy in America is about the same as the other countries. Nationalizing health care financing by imposing a mandatory tax upon the populace is fraught with problems. And, yes, in essence it would meant that health care workers would become employees of the federal government. Although localizing such an activity (on the state, county or municipality level) would be the way to go but, alas, not realistic at the present time. As a result, whether we like it or not (and I am not enthused about it), eventually we will probably have some form of socialized medicine in America.

There are five entities that cause the health care crisis.
1) Lawyers
2) Big corporate Medicine
3) Insurance Companies
4) Hospitals
5) Big Pharma
Each of these takes their share of the health care dollar- right off the top.
Together the divide up the pie.
Here is one partial solution. Offshore Hospital boats, with Indian/foreign doctors.
Patients take a tender out to get care, > 12 miles so in international waters.
Inland patients might have it so easy but maybe some cut rate airlines to do the ferry
service. First world medicine at a huge discount. The US heath care establishment would
have to compete with that! People could vote with their feet. The support for a US single pay system would dry up, or – maybe not. Let the forces fight it out for a change.

There are five entities that cause the health care crisis.
1) Lawyers
2) Big corporate Medicine
3) Insurance Companies
4) Hospitals
5) Big Pharma
Each of these takes their share of the health care dollar- right off the top.
Together the divide up the pie.
Here is one partial solution. Offshore Hospital boats, with Indian/foreign doctors.
Patients take a tender out to get care, > 12 miles so in international waters.
Inland patients might have it so easy but maybe some cut rate airlines to do the ferry
service. First world medicine at a huge discount. The US heath care establishment would
have to compete with that! People could vote with their feet. The support for a US single pay system would dry up, or - maybe not. Let the forces fight it out for a change.

First, a pet peeve: the issue should be framed in terms of how a society FINANCES health care. Health care is for all intents and purposes a right i.e. by law a hospital cannot refuse a emergency room patient for want of health insurance), not so the financing of health care. Of the seven major industrialized nations (US, Canada, England, Germany, France, Italy and Japan) all but the US have some form of socialized health insurance for the masses. No, socialized health insurance is not really "insurance" at all-- but that's another matter). America spends far more in health care financing than the other six even though the life expectancy in America is about the same as the other countries. Nationalizing health care financing by imposing a mandatory tax upon the populace is fraught with problems. And, yes, in essence it would meant that health care workers would become employees of the federal government. Although localizing such an activity (on the state, county or municipality level) would be the way to go but, alas, not realistic at the present time. As a result, whether we like it or not (and I am not enthused about it), eventually we will probably have some form of socialized medicine in America.

Ultimately big insurance has to go, or be diminished, as some version of single payer or universal health policy is the only solution.

It almost sounded like that was what Trump had in mind when he described what his health plan would be like, but now we know differently.

In the UK there is a national health service that provides free at point of service care to everyone, but even so about 10% of the population take out private health care insurance, because they believe it offers them value, like for example the ability to skip waiting lists, getting superior accommodations and food, etc. People also pay to take out travel health insurance policies, especially if they are planning to visit the US.

US health insurance companies need to learn how to offer plans that people actually want or that their employers want employees to have, not ones that they are mandated to buy, that is all.

Once everyone has personal health coverage, then other costs can come down, like Workers Comp insurance, driver's insurance, etc. as there will be no need for them.

Another advantage the UK has in health care cost containment that hospitals and primary care practices have no army of accountants or billing departments, because there is no individual billing or processing of payments , except for foreign visitors, hence saving billions of pounds/dollars.

There are actually MORE bureaucrats and other non-medical people running the British National Health Service than in other countries, the USA included. There are many life-saving procedures and drugs that the NHS will not provide because of cost…hence “death panels” are alive and well.
Closer to home, the Canadian system works well for cuts and bruises and other minor medical procedures, but for complicated procedures, the wait can be interminable. In fact, in border cities, such as Detroit, there are “special agreements” with OHIP (Ontario Health Insurance Program) and Detroit hospitals to provide some of the specialized treatments that are unavailable in Canada on a timely basis.
Canadian medical personnel are first-rate, but have to work under a system that undermines their professional judgment due to delays in treatment.
A number of years ago, some Canadian hospitals were making their CAT scanners available to veterinarians for animal scans while human patients were forced to wait for CAT scan use, as veterinarians would pay cash up front.
Also, if and when Canadian hospitals run out of money (prior to the new fiscal year) they shut down operations.
To its credit, the Canadian Supreme Court ruled that its citizens could purchase private health insurance. Previous to the court’s decision, it was illegal to purchase “health care” outside of the government system.
The Canadian system works as well as it does as Canada’s population is much less than that of the USA and is mostly concentrated within 100 miles of the US border.

On the other hand, single-payer would be the easiest way to outlaw abortion in the US. Outlaw private competitive medical practice-- as Sweden does, but the UK doesn't, yet-- then apply the Hyde Amendment to the result.

US healthcare reform efforts always focus on health insurance rather than healthcare; ie. the debate over whether to adopt single-payer, a public option (people buy into medicare), or subsidized private insurance (romney-/obama-/trumpcare).

i encourage everyone to read karl denninger. his proposals are real healthcare reform. fun fact, most countries with “single-payer,” don’t actually have single payer. what they have is a regulated basic bundle of things health insurers must cover, regulated prices for basic and emergency services, and subsidies to buy insurance for low-income people.

real healthcare reform:
1. providers must post prices, and issue written estimates valid for 90 days upon request
2. the government will maintain a database of prices
3. er prices may vary based on severity at time of admission (critical, stable, etc)
4. the er price can’t exceed 110% of the cost for the equivalent service in a non-emergency setting (extra 10% is to cover higher er fixed costs)
5. prices are “all-in,” no extra costs
6. drug and medical equipment manufacturers must sell at the same wholesale price throughout the country
7. rx drugs and medical equipment wholesale prices cannot exceed the average price sold in countries with pcGDP >= 80% of US pcGDP at ppp
8. eliminate obamacare, medicaid, and schip. all citizens can now buy medicare, which will become a subsidized non-profit (fica tax). if revenues + fica exceed 105% of costs the extra money will be applied to the premiums of people who’ve been enrolled for at least 2 years.
9. keep the exchanges, but ignore state residency.
10. exchange policies:
a. accident and critical illness coverage – lump sum payment to cover accidents, and major illnesses. no pre-existing conditions coverage (payment is equal to costs for equal treatment in va system)
b. bronze – choose 3 of the 10 essential health benefits
c. silver – choose 7 of 10 essential health benefits
d. gold – all 10 benefits
11. exchange policies can only charge premiums. no co-pays, or co-insurance. no deductibles for accident and critical illness coverage.
12. deductibles capped at higher of 10% of gross income, or 25% of after-tax income above 2x poverty level (deductible = out-of-pocket max)
13. non-citizens must purchase at least accident and illness coverage
14. cdc or his will determine which illnesses are “critical”

There are actually MORE bureaucrats and other non-medical people running the British National Health Service than in other countries, the USA included. There are many life-saving procedures and drugs that the NHS will not provide because of cost...hence "death panels" are alive and well.
Closer to home, the Canadian system works well for cuts and bruises and other minor medical procedures, but for complicated procedures, the wait can be interminable. In fact, in border cities, such as Detroit, there are "special agreements" with OHIP (Ontario Health Insurance Program) and Detroit hospitals to provide some of the specialized treatments that are unavailable in Canada on a timely basis.
Canadian medical personnel are first-rate, but have to work under a system that undermines their professional judgment due to delays in treatment.
A number of years ago, some Canadian hospitals were making their CAT scanners available to veterinarians for animal scans while human patients were forced to wait for CAT scan use, as veterinarians would pay cash up front.
Also, if and when Canadian hospitals run out of money (prior to the new fiscal year) they shut down operations.
To its credit, the Canadian Supreme Court ruled that its citizens could purchase private health insurance. Previous to the court's decision, it was illegal to purchase "health care" outside of the government system.
The Canadian system works as well as it does as Canada's population is much less than that of the USA and is mostly concentrated within 100 miles of the US border.

There are many life-saving procedures and drugs that the NHS will not provide because of cost…

but they’ll cover the cost of a female-to-male tranny who wants to bear a child before she has it all removed. This isn’t a joke, it’s current policy being taken advantage of now:

On the other hand, single-payer would be the easiest way to outlaw abortion in the US. Outlaw private competitive medical practice– as Sweden does, but the UK doesn’t, yet– then apply the Hyde Amendment to the result.

Insurance exists to indemnify losses caused by perils, which are caused by hazards. Doing that works quite well. It is also normal that insurance companies (who already have these financial understructures and lots of actuaries), decide to get into other probablistic enterprises, in which they are essentially trying to guess more correctly than the buyers, when something will happen. The famous one is “death”, in which they have learned to play BOTH sides of the better-guesser game by offering BOTH life insurance AND annuities.

Doing any other thing with insurance, gets you into la-la-land territory.

Ultimately big insurance has to go, or be diminished, as some version of single payer or universal health policy is the only solution.

It almost sounded like that was what Trump had in mind when he described what his health plan would be like, but now we know differently.

In the UK there is a national health service that provides free at point of service care to everyone, but even so about 10% of the population take out private health care insurance, because they believe it offers them value, like for example the ability to skip waiting lists, getting superior accommodations and food, etc. People also pay to take out travel health insurance policies, especially if they are planning to visit the US.

US health insurance companies need to learn how to offer plans that people actually want or that their employers want employees to have, not ones that they are mandated to buy, that is all.

Once everyone has personal health coverage, then other costs can come down, like Workers Comp insurance, driver's insurance, etc. as there will be no need for them.

Another advantage the UK has in health care cost containment that hospitals and primary care practices have no army of accountants or billing departments, because there is no individual billing or processing of payments , except for foreign visitors, hence saving billions of pounds/dollars.

Ultimately big insurance has to go, or be diminished, as some version of single payer or universal health policy is the only solution.

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